类风湿关节炎患者肿瘤坏死因子抑制剂的长期药物生存。
Longterm Drug Survival of Tumor Necrosis Factor Inhibitors in Patients with Rheumatoid Arthritis.
机构信息
From the Leeds Institute of Rheumatic and Musculoskeletal Medicine, and Leeds National Institute for Health Research (NIHR) Biomedical Research Centre, The Leeds Teaching Hospitals Trust, Leeds, UK.
P. Emery, FMedSci, Leeds Institute of Rheumatic and Musculoskeletal Medicine, and Leeds NIHR Biomedical Research Centre, The Leeds Teaching Hospitals Trust; B. Vlahos, MBA, Pfizer Inc.; P. Szczypa, MD, Pfizer Ltd.; M. Thakur, MD, Pfizer Ltd.; H.E. Jones, RN, Pfizer Inc.; J. Woolcott, PhD, Pfizer Inc.; P.V. Santos Estrella, MD, Pfizer Inc.; C. Rolland, PhD, Envision Pharma Group; A. Gibofsky, MD, Weill Medical College; G. Citera, MD, Instituto de Rehabilitación Psicofísica de Buenos Aires; S. Sockalingam, MMed, University Malaya Medical Centre; L. Marshall, PhD, Pfizer Inc.
出版信息
J Rheumatol. 2020 Apr;47(4):493-501. doi: 10.3899/jrheum.181398. Epub 2019 Jun 1.
OBJECTIVE
To evaluate longterm drug survival (proportion of patients still receiving treatment) and discontinuation of etanercept (ETN), infliximab (IFX), adalimumab (ADA), certolizumab pegol (CZP), and golimumab (GOL) using observational data from patients with rheumatoid arthritis (RA).
METHODS
Following a systematic literature review, drug survival at 12 and 12-24 months of followup was estimated by summing proportions of patients continuing treatment and dividing by number of studies. Drug survival at ≥ 36 months of followup was estimated through Metaprop.
RESULTS
There were 170 publications included. In the first-line setting, drug survival at 12 months with ETN, IFX, or ADA was 71%, 69%, and 70%, respectively, while at 12-24 months the corresponding rates were 63%, 57%, and 59%. In the second-line setting, drug survival at 12 months with ETN, IFX, or ADA was 61%, 69%, and 55%, respectively, while at 12-24 months the corresponding rates were 53%, 39%, and 43%. Drug survival at ≥ 36 months with ETN, IFX, or ADA in the first-line setting was 59% (95% CI 46-72%), 49% (95% CI 43-54%), and 51% (95% CI 41-60%), respectively, while in the second-line setting the corresponding rates were 56% (95% CI 52-61%), 48% (95% CI 40-55%), and 41% (95% CI 36-47%). Discontinuation of ETN, IFX, and ADA at 36 months of followup was 38-48%, 42-62%, and 38-59%, respectively. Data on CZP and GOL were scarce.
CONCLUSION
After > 12 months of followup, more patients with RA receiving ETN remain on treatment compared with other tumor necrosis factor inhibitors.
目的
利用类风湿关节炎（RA）患者的观察性数据，评估依那西普（ETN）、英夫利昔单抗（IFX）、阿达木单抗（ADA）、培塞利珠单抗（CZP）和戈利木单抗（GOL）的长期药物生存率（仍接受治疗的患者比例）和停药情况。
方法
在系统文献回顾后，通过将继续治疗的患者比例相加并除以研究数量，估计了 12 个月和 12-24 个月随访时的药物生存率。通过 Metaprop 估计了≥36 个月随访时的药物生存率。
结果
共纳入了 170 篇文献。在一线治疗中，ETN、IFX 或 ADA 的 12 个月药物生存率分别为 71%、69%和 70%，12-24 个月时相应的生存率分别为 63%、57%和 59%。在二线治疗中，ETN、IFX 或 ADA 的 12 个月药物生存率分别为 61%、69%和 55%，12-24 个月时相应的生存率分别为 53%、39%和 43%。在一线治疗中，ETN、IFX 或 ADA 的≥36 个月药物生存率分别为 59%（95%CI 46-72%）、49%（95%CI 43-54%）和 51%（95%CI 41-60%），而在二线治疗中相应的生存率分别为 56%（95%CI 52-61%）、48%（95%CI 40-55%）和 41%（95%CI 36-47%）。在 36 个月的随访中，ETN、IFX 和 ADA 的停药率分别为 38-48%、42-62%和 38-59%。关于 CZP 和 GOL 的数据很少。
结论
在 12 个月以上的随访中，接受 ETN 治疗的 RA 患者中，继续接受治疗的患者比例高于其他肿瘤坏死因子抑制剂。
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